Patient-reported outcome measures for chronic obstructive pulmonary disease: the exclusion of people with low literacy skills and learning disabilities

<p>Background: Patient-reported outcome measures (PROMs) are intended to reflect outcomes relevant to patients. They are increasingly used for healthcare quality improvement. To produce valid measures, patients should be involved in the development process but it is unclear whether this usually includes people with low literacy skills or learning disabilities. This potential exclusion raises concerns about whether these groups will be able to use these measures and participate in quality improvement practices.</p> <p>Methods: Taking PROMs for chronic obstructive pulmonary disease (COPD) as an exemplar condition, our review determined the inclusion of people with low literacy skills and learning disabilities in research developing, validating, and using 12 PROMs for COPD patients. The studies included in our review were based on those identified in two existing systematic reviews and our update of this search. Results People with low literacy skills and/or learning disabilities were excluded from the development of PROMs in two ways: explicitly through the participant eligibility criteria and, more commonly, implicitly through recruitment or administration methods that would require high-level reading and cognitive abilities. None of the studies mentioned efforts to include people with low literacy skills or learning disabilities.</p> <p>Conclusion: Our findings suggest that people with low literacy skills or learning disabilities are left out of the development of PROMs. Given that implicit exclusion was most common, researchers and those who administer PROMs may not even be aware of this problem. Without effort to improve inclusion, unequal quality improvement practices may become embedded in the health system.</p&gt

Testing and validating the CERES-wheat (Crop Estimation through Resource and Environment Synthesis-wheat) model in diverse environments

CERES-Wheat is a computer simulation model of the growth, development, and yield of spring and winter wheat. It was designed to be used in any location throughout the world where wheat can be grown. The model is written in Fortran 77, operates on a daily time stop, and runs on a range of computer systems from microcomputers to mainframes. Two versions of the model were developed: one, CERES-Wheat, assumes nitrogen to be nonlimiting; in the other, CERES-Wheat-N, the effects of nitrogen deficiency are simulated. The report provides the comparisons of simulations and measurements of about 350 wheat data sets collected from throughout the world

Spin-dependent transport in a quasiballistic quantum wire

We describe the transport properties of a 5 $\mu$m long one-dimensional (1D) quantum wire. Reduction of conductance plateaux due to the introduction of weakly disorder scattering are observed. In an in-plane magnetic field, we observe spin-splitting of the reduced conductance steps. Our experimental results provide evidence that deviation from conductance quantisation is very small for electrons with spin parallel and is about 1/3 for electrons with spin anti-parallel. Moreover, in a high in-plane magnetic field, a spin-polarised 1D channel shows a plateau-like structure close to $0.3 \times e^2/h$ which strengthens with {\em increasing} temperatures. It is suggested that these results arise from the combination of disorder and the electron-electron interactions in the 1D electron gas.Comment: 4 pages, 5 figures, latex to be published in Phys. Rev. B (15/3/2000

The cognitive consequences of the COVID-19 epidemic: collateral damage?

Recovery from coronavirus disease 2019 (COVID-19) will be principally defined in terms of remission from respiratory symptoms; however, both clinical and animal studies have shown that coronaviruses may spread to the nervous system. A systematic search on previous viral epidemics revealed that while there has been relatively little research in this area, clinical studies have commonly reported neurological disorders and cognitive difficulties. Little is known with regard to their incidence, duration or underlying neural basis. The hippocampus appears to be particularly vulnerable to coronavirus infections, thus increasing the probability of post-infection memory impairment, and acceleration of neurodegenerative disorders such as Alzheimer’s disease. Future knowledge of the impact of COVID-19, from epidemiological studies and clinical practice, will be needed to develop future screening and treatment programmes to minimize the long-term cognitive consequences of COVID-19

Calving Difficulty in Beef Cattle: Part II

Many cattlemen believe reducing dietary energy during late pregnancy will decrease fetal size resulting in improved calving ease, whereas increasing energy will increase fetal size leading to a higher incidence of dystocia. Generally speaking, research has shown that lowering the energy allowance will decrease birth weight but will not significantly reduce dystocia. At MARC, Hereford and Angus 2-year-old heifers were fed three levels of energy (10.8, 13.7 or 17 .0 lb TDN/head/day) for 90 days prior to calving. Increasing the level of dietary energy resulted in increased birth weight but not increased dystocia; in fact, the incidence of calving difficulty was lower in the medium and high energy groups than in the low energy group

The cognitive consequences of the COVID-19 epidemic: collateral damage?

Recovery from coronavirus disease 2019 (COVID-19) will be principally defined in terms of remission from respiratory symptoms, however both clinical and animal studies have shown that coronaviruses may spread to the nervous system. A systematic search on previous viral epidemics revealed that while there has been relatively little research in this area, clinical studies have commonly reported neurological disorders and cognitive difficulties. Little is known with regard to their incidence, duration or underlying neural basis. The hippocampus appears to be particularly vulnerable to coronavirus infections, thus increasing the probability of post-infection memory impairment, and acceleration of neurodegenerative disorders such as Alzheimer’s disease. Future knowledge of the impact of COVID-19, from epidemiological studies and clinical practice, will be needed to develop future screening and treatment programmes to minimize the long-term cognitive consequences of COVID-19

Calving Difficulty in Beef Cattle: Part I

Calving difficulty (dystocia) can increase calf losses, cow mortality, and veterinary and labor costs, as well as delay return to estrus, and lower conception rates. In two studies at the U.S. Meat Animal Research Center (MARC), Clay Center, Nebraska, calf losses within 24 hours of birth averaged 4 percent for those born with little or no assistance compared to 16 percent for those requiring assistance. Calf mortality increased by a 0.35 percent per pound increase in birth weight. In a Hereford herd at the U.S. Livestock and Range Research Station. Miles City, Montana, 57 percent of all calf losses were reported to be due to dystocia